Functional Hypothalamic Amenorrhoea
Understanding Functional Hypothalamic Amenorrhea (FHA)
Functional Hypothalamic Amenorrhea (FHA) is a condition where menstruation stops due to decreased activity from the hypothalamus, a part of the brain that regulates many bodily functions, including the menstrual cycle. FHA is often caused by stress, significant weight loss, excessive exercise, or a combination of these factors.
Risk Factors for FHA
Several factors can increase the risk of developing FHA, including:
- Excessive exercise: High levels of physical activity, especially without adequate caloric intake.
- Stress: Emotional or psychological stress can disrupt hormonal balance.
- Low body weight: Being underweight or having a low body fat percentage.
- Eating disorders: Conditions like anorexia nervosa or bulimia.
- Nutritional deficiencies: Poor nutrition or restrictive diets
- Genetic predisposition: Family members with FHA
Recognising the Symptoms
The primary symptom of FHA is the absence of menstrual periods for three months or more. Other symptoms may include:
- Cold hands and feet: Due to reduced metabolic rate.
- Hair loss or thinning: Resulting from hormonal imbalances.
- Low libido: Decreased interest in sexual activity.
- Low energy levels: General fatigue and lack of vitality
- Impaired immune health: Increased coughs and colds and poor
- Poor recovery: Prolonged recovery from injury or exercise
Diagnostic Methods for Functional Hypothalamic Amenorrhea
Diagnosing FHA involves ruling out other causes of amenorrhea. Your doctor may use several methods to diagnose FHA:
- Medical history and physical exam: Assessing lifestyle factors, stress levels, and physical health.
- Blood tests: Measuring levels of hormones such as FSH, LH, and oestradiol and excluding other causes of absent periods
- Imaging tests: Ultrasound to check for structural abnormalities in the reproductive organs
Steps to Take if You Suspect you Have FHA
Anyone who goes three months without a period requires medical review. Keeping a record of your menstrual cycle and any symptoms can help your doctor make an accurate diagnosis
Treatment Options
Treatment for FHA focuses on addressing the underlying causes and may include:
- Lifestyle changes: Increasing caloric intake, reducing exercise intensity, and managing stress through relaxation techniques.
- Nutritional support: Working with a dietitian to ensure adequate nutrition and caloric intake.
- Psychological support: Counselling or therapy to address stress, anxiety, or eating disorders.
- Hormone therapy: In some cases, topical hormone replacement therapy may be recommended to protect bone health. The combined oral contraceptive pill is NOT recommended in in FHA and does not protect bone health.
Dr Smith’s Blog Posts on Metabolic Health
Click to read more:
The Importance of Treatment
Treating FHA is crucial to prevent long-term complications such as bone loss (osteoporosis), infertility, and cardiovascular issues. Restoring regular menstrual cycles can improve overall health and reduce the risk of these complications. There is no specific medication or treatment that can reverse FHA but most people can restore menstrual cycles with lifestyle changes.